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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number
42-1707837
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) PATTERSON DENTAL
1031 MENDOTA HEIGHTS ROAD
ST PAUL,MN55120 		41-1833619   120,780       DENTISTRY CLINIC
(2) HENNEPIN COUNTY
300 S 6TH STREET
MINNEAPOLIS,MN55487 		41-6005801 GOVERNMENT 87,015       PCA ASSESSMENT
(3) DESIGN RESEARCH COLLECTIVE
1101 MILTON STREET
ST PAUL,MN55103 		82-2143571   59,000       RESEARCH
(4) CATHLENE HOCKERT
622 LABORE ROAD
LITTLE CANADA,MN55117 		47-7824505   45,000       EMERGENCY PREPAREDNESS
(5) AMERICAN CONTRACT SYSTEMS
4801 W 81ST STREET SUITE 110
BLOOMINGTON,MN55437 		41-1816299   40,951       EMERGENCY PREPAREDNESS
(6) UNITED HOSPITAL
333 NORTH SMITH AVENUE
ST PAUL,MN55102 		36-3261413 501(C)(3) 36,206       EMERGENCY PREPAREDNESS
(7) FAIRVIEW HEALTH SERVICES
333 NORTH SMITH AVENUE
ST PAUL,MN55102 		41-0991680 501(C)(3) 34,694       EMERGENCY PREPAREDNESS
(8) CHILDRENS HEALTH CARE
2525 CHICAGO AVENUE SOUTH
MINNEAPOLIS,MN55404 		41-1754276 501(C)(3) 21,396       EMERGENCY PREPAREDNESS
(9) MEDLINE INDUSTRIES INC
ONE MEDLINE PL
MUNDELEIN,IL60060 		36-2596612   20,794       EMERGENCY PREPAREDNESS
(10) LAKEVIEW HOSPITAL
927 CHURCHILL STREET WEST
STILLWATER,MN55082 		41-0811697 501(C)(3) 19,682       EMERGENCY PREPAREDNESS
(11) HU FRIEDY MFG CO INC
3232 N ROCKWELL ST
CHICAGO,IL60618 		36-2408089   13,840       DENTISTRY CLINIC
(12) HEALTHEAST ST JOSEPHS HOSPITAL
45 W 10TH STREET
SAINT PAUL,MN55102 		41-0693880 501(C)(3) 13,310       EMERGENCY PREPAREDNESS
(13) INNERLITE INC
6868A CORTONA DRIVE
SANTA BARBARA,CA93117 		77-0563769   12,890       DENTISTRY CLINIC
(14) GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
200 E UNIVERSITY AVE
SAINT PAUL,MN55101 		36-3379150 501(C)(3) 12,764       EMERGENCY PREPAREDNESS
(15) REGIONS HOSPITAL
640 JACKSON STREET
ST PAUL,MN55101 		41-0956618 501(C)(3) 12,093       EMERGENCY PREPAREDNESS
(16) HEALTHEAST CARE SYSTEM
NW 7205 PO BOX 1450
MINNEAPOLIS,MN55485 		36-3517697 501(C)(3) 11,950       EMERGENCY PREPAREDNESS
(17) NORTHFIELD CITY HOSPITAL AUXILIARY
2000 NORTH AVENUE
NORTHFIELD,MN55057 		41-6038368 501(C)(3) 11,797       EMERGENCY PREPAREDNESS
(18) MAYO CLINIC HEALTH SYSTEM NEW PRAGUE
301 SECOND STREET NE
NEW PRAGUE,MN56071 		41-0723639 501(C)(3) 10,973       EMERGENCY PREPAREDNESS
(19) NORTH MEMORIAL HEATH CARE
701 PARK AVENUE SOUTH
MINNEAPOLIS,MN55415 		41-0729979 501(C)(3) 10,938       EMERGENCY PREPAREDNESS
(20) ST FRANCIS REGIONAL MEDICAL CENTER
1455 ST FRANCIS AVENUE
SHAKOPEE,MN55379 		41-0907986 501(C)(3) 10,250       EMERGENCY PREPAREDNESS
(21) ABBOTT NORTHWESTERN HOSPITAL
800 E 29TH STREET
MINNEAPOLIS,MN55407 		36-3261413 501(C)(3) 9,700       EMERGENCY PREPAREDNESS
(22) ALLINA HEALTH SYSTEMS
PO BOX 43
MINNEAPOLIS,MN55440 		36-3261413 501(C)(3) 31,683       EMERGENCY PREPAREDNESS FOR MERCY HOSPITAL, UNITY HOSPITAL & REGINA MEDICAL CENTER
(23) MAPLE GROVE HOSPITAL CORPORATION
9875 HOSPTIAL DRIVE
MAPLE GROVE,MN55369 		20-8316475 501(C)(3) 7,075       EMERGENCY PREPAREDNESS
(24) DENTSPLY TULSA DENTAL SPECIALTIES
5100 E SKELLY DR STE 300
TULSA,OK74135 		23-2830736   6,565       DENTISTRY CLINIC
(25) FORMLABS INC
35 MEDFORD STREET SUITE 201
SOMERVILLE,MA02143 		45-3644301   6,439       DENTISTRY CLINIC
(26) PHILLIPS EYE INSTITUTE
2215 PARK AVENUE
MINNEAPOLIS,MN55404 		  6,234       EMERGENCY PREPAREDNESS
(27) MLCV STLP LLC
1500 PARK PLACE BLVD
MINNEAPOLIS,MN55416 		47-4478706   6,232       EMERGENCY PREPAREDNESS
(28) UNIVERSITY OF MINNESOTA
222 21ST AVENUE SOUTH
MINNEAPOLIS,MN554550439 		41-6007513 GOVERNMENT 6,038       EMERGENCY PREPAREDNESS
(29) COMTEC CONSULTANTS INC
2400 VETERANS MEMORIAL BLVD SUITE
205
KENNER,MN70062 		72-1326801   5,970       EMERGENCY PREPAREDNESS
(30) HEALTHEAST ST JOHNS HOSPITAL
1575 BEAM AVENUE
MAPLEWOOD,MN55379 		41-1456897 501(C)(3) 5,745       EMERGENCY PREPAREDNESS
(31) PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BOULEVARD
ST LOUIS PARK,MN55426 		41-0132080 501(C)(3) 5,195       EMERGENCY PREPAREDNESS
(32) RIDGEVIEW MEDICAL CENTER
500 SOUTH MAPLE STREET
WACONIA,MN55387 		31-1667875 501(C)(3) 5,067       FAMILY HEALTH
(33) OREGON PRIMARY CARE ASSOCIATION
333 SW 5TH AVENUE SUITE 250
PORTLAND,OR97204 		93-0877986   5,000       EMERGENCY PREPAREDNESS
(34) HENNEPIN HEALTH RESEARCH INSTITUTE
701 PARK AVENUE PP7700
MINNEAPOLIS,MN55415 		41-1677920 501(C)(3) 318,281       RESEARCH PROGRAM SUPPORT
(35) STAIRSTEP FOUNDATION
1404 14TH AVE N
MINNEAPOLIS,MN55411 		41-1709346 501(C)(3) 75,000       PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
22
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
13
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2018
Page 2

Schedule I (Form 990) 2018
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: THE HENNEPIN HEALTH FOUNDATION RAISES AND ADMINISTERS PHILANTHROPIC SUPPORT FOR HENNEPIN HEALTHCARE SYSTEM, INC. THE SUPPORT INCLUDES A GRANT MANAGEMENT DEPARTMENT WHICH COORDINATES THE TASK OF MONITORING GRANT RECEIPTS AND GRANT DISBURSEMENTS FROM FEDERAL, STATE, LOCAL OR INDIVIDUAL BENEFICIARIES. THE HENNEPIN HEALTH FOUNDATION WORKS CLOSELY WITH HHS TO ENSURE PROPER CONTROLS ARE IN PLACE BY USE OF RECONCILIATIONS AND COMPLIANCE MONITORING AND REPORTING.
Schedule I (Form 990) 2018



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